天津医药

• 临床论丛 • 上一篇    下一篇

35例特发性正常压力性脑积水的诊断与治疗

李罡   

  1. 天津市第五中心医院脑系科
  • 收稿日期:2010-08-06 修回日期:2011-03-04 出版日期:2011-07-15 发布日期:2011-07-15
  • 通讯作者: 李罡

The Diagnosis and Treatment of Idiopathic Normal Pressure Hydrocephalus (with report of 35 cases)

  • Received:2010-08-06 Revised:2011-03-04 Published:2011-07-15 Online:2011-07-15

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摘要： 摘要 目的：总结特发性正常压力性脑积水的临床诊断及治疗体会。方法：对本单位在2008.9～2010.6收治的35例特发性正常压力性脑积水患者的临床资料进行回顾性分析，对比手术前后患者临床症状的缓解情况。结果：本组患者接受脑室腹腔分流术后,术前症状皆得到不同程度的缓解。其中步态异常（85.7%），认知障碍（91.4%），小便失禁（82.4%）。13例患者症状得到全部缓解，其余患者至少一种症状得到缓解。结论：特发性正常压力性脑积水是神经科常见病之一，临床工作中易误诊及漏诊需引起重视。脑室腹腔分流术是治疗特发性正常压力性脑积水的有效方法，但应掌握手术指征；腰穿检查及脑脊液释放试验可用于手术病例选择，以提高手术效果。

关键词: 特发性正常压力性脑积水, 脑室腹腔分流术, 认知障碍, 步态异常, 脑脊液释放试验

Abstract: Abstract Objective: To explore the clinical diagnosis and treatment in patients with idiopathic normal pressure hydrocephalus (iNPH). Methods: Clinical data of 35 patients with iNPH in our department from September 2008 to June 2010 were analyzed, the symptoms before and after operation have been compared. Results: Among 35 iNPH patients have been operated by ventriculoperitoneal shunt, all of them have improved in clinical symptoms in varying degrees. gait disturbance(85.7%), dementia(91.4%), urinary incontinence(82.4%). 13 patients have improved in all symptoms, the remains have one symptom improved at least. Conclusion: iNPH is one of the common diseases in neurology which can be misdiagnosis and missed diagnosis. Ventriculoperitoneal shunt is effective method for it. Lumbar puncture and tap test can be used to select patients for operation.

Key words: idiopathic normal pressure hydrocephalus, ventriculoperitoneal shunt, dementia, gait disturbance, Tap test